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Predictive Biomarkers in Thyroid Cancer
Elisabetta Macerola1, Anello Marcello Poma1, Paola Vignali1
1Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.
Abstract:
In molecular pathology, predictive biomarkers identify which patients are likely to respond to targeted drugs. These therapeutic agents block specific molecules directly involved in cancer growth, dedifferentiation and progression. Until few years ago, the only targeted drugs available for advanced thyroid cancer included multi-tyrosine kinase inhibitors, mainly targeting the MAPK pathway and the angiogenic signaling. The administration of these drugs does not necessarily require a molecular characterization of tumors to assess the presence of predictive alterations. However, the availability of new selective targeted drugs for thyroid cancer patients is changing the diagnostic strategies for the molecular characterization of these tumors. The search for targetable alterations can be performed directly on tumor tissue by using a variety of methodologies, depending also on the number and type of alterations to test (i.e. single nucleotide variation or gene rearrangement). Herein, a comprehensive review of the currently available targeted treatments for thyroid cancer, related predictive markers and testing methodologies is provided.
Insights
Predictive biomarkers are crucial for identifying patients who will benefit from targeted cancer drugs. New selective therapies for advanced thyroid cancer necessitate molecular tumor characterization to guide treatment selection.
Area of Science:
- Molecular pathology
- Oncology
- Pharmacogenomics
Background:
- Targeted drugs in advanced thyroid cancer historically included multi-tyrosine kinase inhibitors (TKIs) primarily targeting MAPK and angiogenic pathways.
- These older TKIs often did not require extensive molecular profiling for patient selection.
- The landscape of thyroid cancer treatment is evolving with the introduction of new, selective targeted drugs.
Purpose of the Study:
- To provide a comprehensive review of current targeted treatments for advanced thyroid cancer.
- To discuss the predictive biomarkers associated with these targeted therapies.
- To outline the various methodologies used for molecular characterization of thyroid tumors.
Main Methods:
- Review of current literature on targeted therapies and predictive biomarkers in thyroid cancer.
- Analysis of diagnostic strategies and molecular testing methodologies.
- Categorization of alterations (e.g., single nucleotide variation, gene rearrangement).
Main Results:
- The advent of new selective targeted drugs is shifting diagnostic paradigms in thyroid cancer.
- Molecular characterization of tumors is becoming essential for personalized treatment selection.
- Various testing methodologies exist, chosen based on the type and number of alterations to be assessed.
Conclusions:
- Predictive biomarkers are key to optimizing targeted therapy selection in molecular pathology.
- Advanced thyroid cancer treatment is increasingly reliant on molecular profiling for efficacy.
- Understanding available testing methodologies is crucial for implementing personalized medicine approaches in thyroid cancer.
